Action Against Hunger - Pakistanhttp://www.actionagainsthunger.org/taxonomy/countries/asia/pakistan
enResearch in Action: Enhancing a Child Nutrition Program in Pakistanhttp://www.actionagainsthunger.org/blog/research-action-enhancing-child-nutrition-program-pakistan
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<div class="field-item even" rel="schema:image" resource="http://www.actionagainsthunger.org/sites/default/files/images/blog-posts/DSC00827.jpg"><img typeof="foaf:Image" src="http://www.actionagainsthunger.org/sites/default/files/images/blog-posts/DSC00827.jpg" width="4320" height="3240" alt="photo" title="Sorath Soomro, a Hygiene Promoter-Data Gatherer for the study team, conducts a follow-up visit with 30-year-old Zareena, who has brought her daughter Uzma to the Community Management of Acute Malnutrition (CMAM) site in Jhalo, Pakistan on May 18, 2016. Photo: Ann Norinne Suk" />
<div class="caption">Sorath Soomro, a Hygiene Promoter-Data Gatherer for the study team, conducts a follow-up visit with 30-year-old Zareena, who has brought her daughter Uzma to the Community Management of Acute Malnutrition (CMAM) site in Jhalo, Pakistan on May 18, 2016. Photo: Ann Norinne Suk</div>
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</div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="schema:text content:encoded"><p>In Pakistan, malnutrition remains a big health challenge. It’s correlated with high levels of poverty, and it’s evident in low rates of food consumption and also inadequate nutrient intake. Malnutrition is linked to morbidity and mortality, and its impact on young children in the nation’s rural Sindh Province has become alarming.</p>
<p>At Action Against Hunger, it is our goal to continuously evaluate our programs in the hopes of enhancing them and helping more people achieve positive health outcomes. Here in Sindh, we have partnered with the Johns Hopkins Bloomberg School of Public Health and received funding from the Research for Health in Humanitarian Crises grant. Our research evaluates the effectiveness of three water treatment devices—ceramic filters, Aquatabs, and PUR sachets—as components added to community management of acute malnutrition (CMAM) interventions. We currently operate outpatient therapeutic program (OTP) sites to treat child undernutrition in the Dadu area, and this study on the impacts of adding in a safe drinking water program component is being tested out at 20 of these sites.</p>
<p>Our staff is busy enrolling participants, measuring children with severe acute malnutrition, demonstrating water treatment devices, conducting health and hygiene promotion activities, maintaining participant records, following up with and monitoring participants’ health, and doing exit interviews with participants.</p>
<p>Research like this is never without its challenges. We are working in government health units, with considerable limitations in terms of space and resources. There is limited furniture for us to use while collecting data. It is worthwhile, however, because working in these facilities allows us and the government employees to get to know one another better, share opinions, and develop an important professional rapport.</p>
<p>Another challenge stems from local concepts about undernutrition. There is limited health education through the health system or the media, and many people don’t have access to well-stocked health facilities. Because of this, people often use traditional methods to combat undernutrition in children. Some people pass their baby underneath a camel’s leg two or three times in an attempt to cure the child. Others weigh the baby using <em>taaraji</em>, locally-made spring scales. In this method, they place the baby on one side of the balance and on the other side place shoes instead of iron weights. With the passage of time people are moving away from these practices and seeking other methods to cope with malnutrition; however, these traditions remain in some parts of Dadu. For these reasons our screening teams face challenges in some villages in encouraging families to enroll at the OTP sites.</p>
<p>Lastly, climate and local conditions can pose a barrier. Summer temperatures in Dadu often exceed 120 degrees Fahrenheit (50 degrees Celsius), posing a number of challenges for our team. Continuing to collect data at OTP sites and in the field in these conditions is challenging, but our team is dedicated and well-motivated despite the intense heat.</p>
<p>Working through these obstacles is well worth it, as we aim to complete study activities and put our knowledge into action. We hope that the results of the study will better inform how CMAM programs can become more effective. We’ll keep you apprised when we have the results in hand.</p>
</div></div></div><span rel="schema:url" resource="/blog/research-action-enhancing-child-nutrition-program-pakistan" class="rdf-meta element-hidden"></span><span property="schema:name" content="Research in Action: Enhancing a Child Nutrition Program in Pakistan" class="rdf-meta element-hidden"></span>Tue, 09 Aug 2016 19:10:55 +0000erapport7719 at http://www.actionagainsthunger.orgBeyond the Numbers: Why Qualitative Research Mattershttp://www.actionagainsthunger.org/blog/beyond-numbers-why-qualitative-research-matters
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</div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="schema:text content:encoded"><p><em>Editor’s Note: REFANI’s Zvia Shwirtz recently sat down with Zubaida Metlo, our Pakistan-based qualitative researcher for the ongoing </em><a href="http://www.actionagainsthunger.org/refani"><em>REFANI</em></a><em> project. REFANI (Research on Food Assistance for Nutritional Impact) is a three-year research project aiming to strengthen the evidence base on the nutritional impact and cost-effectiveness of cash- and voucher-based food assistance programs. In this interview, Zvia and Zubaida discuss the importance of complementing quantitative research with qualitative research. The interview below is an adapted excerpt intended for a broad audience. If you are interested in reading the original interview in full, you may do so </em><a href="http://www.actionagainsthunger.org/publication/2016/05/researching-how-cash-transfers-impact-communities-sindh-pakistan-qa-refani"><em>here</em></a><em>.</em></p>
<p><strong>Zvia Shwirtz (ZS): You work in Pakistan conducting research for the REFANI study. What is your role and experience working in the country?</strong></p>
<p><strong>Zubaida Metlo (ZM): </strong>Currently, I am the qualitative researcher for the REFANI-Pakistan study, working in collaboration between <a href="http://www.actionagainsthunger.org/">Action Against Hunger</a> and <a href="http://www.ennonline.net/">ENN</a>. Previously I worked for the Institute of Water Resources Engineering and Management Science of Mehran University in Pakistan, supporting young scholars and researchers in their field work. I have also worked with the World Bank in Pakistan, as well as conducted my own research on female farmers and access to water in Sindh.</p>
<p><strong>ZS: What is the value of collecting qualitative data, as opposed to quantitative data? </strong></p>
<p><strong>ZM:</strong> Qualitative data is broad, non-statistical, exploratory, and descriptive. So while quantitative data is crucial for recording <em>facts</em> about a group of people such as ethnicity, occupation, or level of poverty, collecting qualitative data reveals <em>insights</em> about their opinions, hopes, and motivations. Combining these two kinds of data helps researchers untangle people’s complicated living circumstances and daily realities, as well as explore their ability to cope with challenging household dynamics – especially when economic and social conditions are bad. </p>
<p><strong>ZS: Why are you collecting qualitative data for the </strong><a href="http://www.actionagainsthunger.org/refani/pakistan-country-study"><strong>REFANI-Pakistan study</strong></a><strong>?</strong></p>
<p><strong>ZM:</strong> Since 2013, Action Against Hunger and its partners have been implementing a program aimed at improving the nutritional status of women in Sindh. This program, known as the Women and Children/Infants Improved Nutrition in Sindh (<a href="http://wins.org.pk/">WINS</a>) program, is well-aligned with the REFANI-Pakistan study. REFANI research is looking at the nutritional status of women and children who only receive WINS educational programming, compared to those who receive cash or vouchers in addition to the education.</p>
<p>The qualitative study has two objectives. The first is to help interpret the quantitative findings on the impact of the different interventions on childhood nutrition status. I really focused on what the recipients chose to spend their cash or voucher on, and why.</p>
<p>The second objective is to investigate the existing social and economic structures in which the subjects of the study live – both in broader communities and in individual households. I tried to find out: who provides care for the family during difficult periods? Who makes decisions on child health and nutrition? Do they receive help from relatives? How do they generate an income? Since poverty is just one factor affecting child nutrition, I also dove deeper to find out the details about nutritional status, food security, health care, women’s empowerment, and household dynamics.</p>
<p><strong>ZS: What kind of qualitative data are you collecting, and what valuable information will it reveal?</strong></p>
<p><strong>ZM:</strong> The qualitative data collected covers two separate time periods—during the cash distribution, and post-distribution. The data was collected from two groups—poor and very poor households, and mothers with and without malnourished children.</p>
<p>We collected all of the data through focus group discussions and interviews. We also gathered 114 village profiles which helped establish the social, cultural, and economic context in which the study was set. In addition to the local population and cash/voucher recipients, we spoke with Action Against Hunger staff, WINS staff, REFANI field officers, NGO staff based in the community, and a wide range of people who work in health, education, and public administration in Pakistan. Talking to so many people allowed us to get a wider, deeper picture of how the community as a whole feels about the intervention.</p>
<p>Since we had multiple rounds of data collection for each type of interview, at different time periods, we were able to take note of changes in the lives of the recipients as the intervention continued, and after it ended. This month we’re collecting the last round of qualitative data which will show us how households have managed in the six months since the intervention has ended.</p>
<p><strong>ZS: How may the qualitative data fill some of the evidence gaps that exist on the nutritional impact of cash-and-voucher based food assistance?</strong></p>
<p><strong>ZM:</strong> There is great value in collecting qualitative data for the REFANI-Pakistan study. It will bolster the quantitative data by filling in some of the evidence gaps identified in the <a href="http://www.actionagainsthunger.org/publication/2015/09/refani-literature-review">REFANI Literature Review</a>. Specifically, I believe we can begin to answer some questions we have about the community and make informed inferences on the current nutritional situation. If we know how they view child health, what they spend their money on, and what motivates them to act, then we might be able to help them better in the future.</p>
<p><strong>ZS: Do you think that qualitative data and analysis on cash interventions could inform future policies or programs?</strong></p>
<p><strong>ZM:</strong> Yes! That is the overall aim of the REFANI project, to produce robust evidence which can advise and influence key decision makers in policy and practice.</p>
<p><strong>ZS: Can you share any interesting results from the preliminary analysis of the data?</strong></p>
<p><strong>ZM:</strong> I am currently in the process of analyzing the data, and I still have one more round of data collection. However, I can say that the results will be very interesting. Stay tuned!</p>
<p><em>This material has been funded by UK aid from the UK government, and co-financed through humanitarian aid from the European Commission; however the views expressed do not necessarily reflect the UK government’s official policies, or the official opinion of the European Union.</em></p>
</div></div></div><span rel="schema:url" resource="/blog/beyond-numbers-why-qualitative-research-matters" class="rdf-meta element-hidden"></span><span property="schema:name" content="Beyond the Numbers: Why Qualitative Research Matters" class="rdf-meta element-hidden"></span>Mon, 18 Jul 2016 15:25:25 +0000erapport7705 at http://www.actionagainsthunger.orgWater Treatment In Sindh Province: The Chulli Improved Cooking Stovehttp://www.actionagainsthunger.org/publication/2016/01/water-treatment-sindh-province-chulli-improved-cooking-stove
<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>This case study introduces tests completed in the province of Sindh in Southern Pakistan on improved cooking stoves known as Chulli. The Chulli enables water treatment through the use of a water heating mechanism.</p>
</div></div></div><div class="field field-name-field-pub-file field-type-file field-label-hidden"><div class="field-items"><div class="field-item even" rel="" resource="http://www.actionagainsthunger.org/sites/default/files/publications/WASH_Case_Study_Pakistan_Chulli_Stoves_December_2015_Web_Version.pdf"><span class="file"><img class="file-icon" alt="PDF icon" title="application/pdf" src="/modules/file/icons/application-pdf.png" /> <a href="http://www.actionagainsthunger.org/sites/default/files/publications/WASH_Case_Study_Pakistan_Chulli_Stoves_December_2015_Web_Version.pdf" type="application/pdf; length=1409644">WASH_Case_Study_Pakistan_Chulli_Stoves_December_2015_Web_Version.pdf</a></span></div></div></div><div class="field field-name-field-tax-programs field-type-taxonomy-term-reference field-label-above"><div class="field-label">Programs:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/taxonomy/programs/water-sanitation-hygiene" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Water, Sanitation &amp; Hygiene</a></div></div></div><div class="field field-name-field-tax-lang field-type-taxonomy-term-reference field-label-above"><div class="field-label">Language:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/taxonomy/languages/english" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">English</a></div></div></div><span property="dc:title" content="Water Treatment In Sindh Province: The Chulli Improved Cooking Stove" class="rdf-meta element-hidden"></span>Tue, 05 Jan 2016 16:44:09 +0000jtaveras7626 at http://www.actionagainsthunger.orgReplicating The Sanitation Marketing Model of The Low Cost ‘‘Easy Latrine’’ In Sindh Province, Pakistanhttp://www.actionagainsthunger.org/publication/2016/01/replicating-sanitation-marketing-model-low-cost-easy-latrine-sindh-province
<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>This case study documents the introduction by Action Against Hunger of the sanitation marketing of Easy Latrines in Southern Pakistan and explains its adaptation to the local context, introducing very encouraging initial results with the demand and offer both growing within months after the introduction of the concept.</p>
</div></div></div><div class="field field-name-field-pub-file field-type-file field-label-hidden"><div class="field-items"><div class="field-item even" rel="" resource="http://www.actionagainsthunger.org/sites/default/files/publications/WASH_Case_Study_Pakistan_Easy_Latrines_December_2015_Web_Version.pdf"><span class="file"><img class="file-icon" alt="PDF icon" title="application/pdf" src="/modules/file/icons/application-pdf.png" /> <a href="http://www.actionagainsthunger.org/sites/default/files/publications/WASH_Case_Study_Pakistan_Easy_Latrines_December_2015_Web_Version.pdf" type="application/pdf; length=1453670">WASH_Case_Study_Pakistan_Easy_Latrines_December_2015_Web_Version.pdf</a></span></div></div></div><div class="field field-name-field-tax-programs field-type-taxonomy-term-reference field-label-above"><div class="field-label">Programs:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/taxonomy/programs/water-sanitation-hygiene" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Water, Sanitation &amp; Hygiene</a></div></div></div><div class="field field-name-field-tax-lang field-type-taxonomy-term-reference field-label-above"><div class="field-label">Language:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/taxonomy/languages/english" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">English</a></div></div></div><span property="dc:title" content="Replicating The Sanitation Marketing Model of The Low Cost ‘‘Easy Latrine’’ In Sindh Province, Pakistan" class="rdf-meta element-hidden"></span>Tue, 05 Jan 2016 16:35:08 +0000jtaveras7624 at http://www.actionagainsthunger.orgAccess To Emergency Sanitation For Pakistani Womenhttp://www.actionagainsthunger.org/publication/2016/01/access-emergency-sanitation-pakistani-women
<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>This case study shares the experience of Action Against Hunger in Pakistan to look for solutions to help women address their individual needs for defecation and menstruation.</p>
</div></div></div><div class="field field-name-field-pub-file field-type-file field-label-hidden"><div class="field-items"><div class="field-item even" rel="" resource="http://www.actionagainsthunger.org/sites/default/files/publications/WASH_Case_Study_Pakistan_Female_Sanitation_December_2015_Web_Version.pdf"><span class="file"><img class="file-icon" alt="PDF icon" title="application/pdf" src="/modules/file/icons/application-pdf.png" /> <a href="http://www.actionagainsthunger.org/sites/default/files/publications/WASH_Case_Study_Pakistan_Female_Sanitation_December_2015_Web_Version.pdf" type="application/pdf; length=2008559">WASH_Case_Study_Pakistan_Female_Sanitation_December_2015_Web_Version.pdf</a></span></div></div></div><div class="field field-name-field-tax-programs field-type-taxonomy-term-reference field-label-above"><div class="field-label">Programs:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/taxonomy/programs/water-sanitation-hygiene" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Water, Sanitation &amp; Hygiene</a></div></div></div><div class="field field-name-field-tax-lang field-type-taxonomy-term-reference field-label-above"><div class="field-label">Language:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/taxonomy/languages/english" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">English</a></div></div></div><span property="dc:title" content="Access To Emergency Sanitation For Pakistani Women" class="rdf-meta element-hidden"></span>Tue, 05 Jan 2016 16:30:22 +0000jtaveras7621 at http://www.actionagainsthunger.orgPreventing Acute Malnutrition: Addressing a Global Evidence Gaphttp://www.actionagainsthunger.org/blog/preventing-acute-malnutrition-addressing-global-evidence-gap
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</div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="schema:text content:encoded"><p><em>Editor’s note: The Research on Food Assistance for Nutritional Impact (REFANI) is a three-year research project funded by UK aid from the </em><a href="https://www.gov.uk/government/organisations/department-for-international-development"><em>UK government</em></a><em>, and co-financed through humanitarian aid from the </em><a href="http://ec.europa.eu/echo/"><em>European Commission (ECHO)</em></a><em>. The REFANI </em><em>Consortium is comprised of </em><a href="http://www.actionagainsthunger.org/"><em>Action Against Hunger</em></a><em>, </em><a href="https://www.concern.net/"><em>Concern Worldwide</em></a><em>, the </em><a href="http://www.ennonline.net/"><em>Emergency Nutrition Network (ENN)</em></a><em>, </em><em>and the </em><a href="https://www.ucl.ac.uk/igh"><em>University College London (UCL)</em></a><em>. </em></p>
<p><em>Bridget Fenn, a consultant with the</em> <a href="http://www.ennonline.net/nex/about"><em>Emergency Nutrition Network</em></a><em> and</em><em> Principal Investigator of the</em> <a href="http://www.actionagainsthunger.org/refani"><em>REFANI</em></a> <em>project, discusses the challenges and benefits of doing research on nutrition in complex and challenging environments. </em></p>
<h2><strong>Background</strong></h2>
<p>Acute malnutrition in children under the age of five is an urgent global public health issue. Children with moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) have, respectively, a three- to nine-times greater risk for death when compared to children that are not acutely malnourished. During humanitarian emergencies, the prevalence of acute malnutrition can increase sharply, contributing to high rates of death and suffering.</p>
<p>Food assistance is a major component of the global humanitarian response to emergencies, designed to ensure that communities have assured access to enough nutritious food to meet their daily survival needs. However, rations provided through general food distributions may not meet the greater nutritional requirements of children and pregnant and nursing mothers and thus, they may fail to prevent acute malnutrition among those most vulnerable. Although much food assistance in emergencies is now being provided to affected populations in the form of cash transfers and food vouchers rather than direct distributions of food, there is very little evidence on the impact of these three different forms of food assistance on the nutrition status of those who receive it.</p>
<p>In <a href="http://www.actionagainsthunger.org/refani/pakistan-country-study" target="_blank">Pakistan</a>, <a href="http://www.actionagainsthunger.org/refani/niger-country-study" target="_blank">Niger</a>, and <a href="http://www.actionagainsthunger.org/refani/somalia-country-study" target="_blank">Somalia</a>, REFANI will investigate how food assistance—either as cash or vouchers—can have the greatest impact on the prevention of acute malnutrition in emergencies when it is complemented by other interventions to address both the immediate and underlying causes. REFANI also aims to identify the mechanisms through which this impact is achieved and their cost effectiveness. <strong>Learn more about REFANI at</strong> <a href="http://www.actionagainsthunger.org/refani">http://www.actionagainsthunger.org/refani</a>.</p>
<h2><strong>Q&amp;A with Bridget Fenn</strong></h2>
<p><strong>Q: You are an epidemiologist–a specialist who studies </strong><strong>the patterns, causes, and effects of health and disease in defined populations<strong>–</strong>with a background in nutrition. What kind of research do you usually conduct in your work?</strong></p>
<p><strong>A: </strong>I’ve mainly worked on projects in Pakistan, Niger, and the Amhara region in Ethiopia related to the evaluation of humanitarian interventions which have nutrition-specific or nutrition-sensitive objectives. Nutrition-specific interventions address the immediate causes of undernutrition – such as not having enough food, inadequate feeding or care practices, or having a high rate of infectious diseases. Meanwhile, nutrition-sensitive interventions address the underlying causes of undernutrition – including access to health services and a safe and hygienic environment. The research I conduct focuses on determining whether, and to what extent, the humanitarian interventions are achieving their nutritional objectives (or not).</p>
<p><strong>Q: What are some of the challenges you've faced working on projects in countries experiencing humanitarian crises? </strong></p>
<p><strong>A:</strong> Adequate planning is a critical but an essential challenge in designing and implementing research in humanitarian contexts. However, researchers often have a difficult time anticipating potential problems or obstacles when they are setting up the study. This is especially true in emergencies or crises where the context is changing rapidly. Still, we do everything possible to plan ahead, monitor the situation closely, and adapt as much as we can, while still maintaining consistency in the quality of data collection.</p>
<p>While we often encounter security-related challenges, there are also a wide variety of other challenges that spring up once we’ve already begun to implement a study. For example, excessively high temperatures can not only be exhausting to work in (causing a loss of focus and reduction in outputs), but can also cause problems with equipment. In Pakistan during data collection for REFANI, our hemocues (which measure the amount of hemoglobin in the blood) overheated in the temperatures above 50°C (approximately 122°F). We had to keep them wrapped in damp cloths and positioned next to our car air conditioning units to prevent them from automatically turning off! However, judgments on the quality of this data are yet to be made!</p>
<p><strong>Q: How do you try to mitigate these challenges?</strong></p>
<p><strong>A: </strong>I always say, let’s think in solutions not problems. A committed team which has the ability to approach these situations with flexibility and think creatively in problem solving is also necessary. For example, we had a difficult time recruiting female data collectors for the REFANI project in Pakistan, but working closely and negotiating with the <a href="http://www.actionagainsthunger.org/countries/asia/pakistan">Action Against Hunger team in Pakistan</a> resulted in them providing us with some of their female staff, allowing us to proceed with our research in a timely and appropriate manner.</p>
<p><strong>Q: Most recently, you’ve evaluated programs which provide cash as humanitarian assistance. What are some of the evidence gaps that exist in this type of intervention?</strong></p>
<p><strong>A:</strong> The causal connections between cash transfer programming and nutritional outcomes are very complex, especially in humanitarian contexts. When we give unconditional cash transfers (UCTs), we are giving program beneficiaries the liberty and flexibility to decide themselves how they want to spend the cash resources, and it is often difficult to account for this behavioral element – what will people do with the cash given to them? Will they use it to buy more nutritious foods for their children? Will they use it to pay down their debt? Or will they use it to buy farming equipment? Everyone decides differently and the options are many.</p>
<p>Yet, all of these decisions – whether they are directly related to nutrition or indirectly related – can have an impact on the nutritional outcomes of beneficiary individuals and households. In terms of evidence gaps, we don’t really know what type of intervention works better to achieve a nutrition objective, and in what circumstances. Every agency runs their cash transfer programmes (CTPs) in a different way, just as research projects conduct their investigations with different designs in different contexts, which further contributes to the lack of robust generalizable evidence on what works best to improve and protect nutritional status.</p>
<p><strong>Q: How and where do you see REFANI's research contributing the most?</strong></p>
<p><strong>A:</strong> In the <a href="http://www.actionagainsthunger.org/publication/2015/09/refani-literature-review">REFANI literature review</a>, we outlined both what we do know and what we don’t know about the relationship between food assistance (in-kind, cash, and vouchers) and nutritional impact in humanitarian contexts. We’ve designed REFANI’s research questions specifically to provide some evidence that could be used to fill some of these knowledge “gaps” – particularly around the complex pathways through which cash transfers may achieve nutritional outcomes. REFANI isn’t the first of these studies, but considering the amount of academic and operational input that has gone into its design, more evidence will be produced, and hopefully, similar studies will be conducted in the future, encouraging more research for this field, and ultimately more funding for this evidence which in turn will improve humanitarian programming.</p>
<p><em>Results from the REFANI project are expected in early 2017. In the meantime, the REFANI-Pakistan protocol has been published and can be viewed <a href="http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-2380-3">here</a>. </em></p>
</div></div></div><span rel="schema:url" resource="/blog/preventing-acute-malnutrition-addressing-global-evidence-gap" class="rdf-meta element-hidden"></span><span property="schema:name" content="Preventing Acute Malnutrition: Addressing a Global Evidence Gap" class="rdf-meta element-hidden"></span>Tue, 01 Dec 2015 17:18:55 +0000erapport7590 at http://www.actionagainsthunger.orgEarthquake in Asia: Action Against Hunger Takes Action in Afghanistan and Pakistanhttp://www.actionagainsthunger.org/blog/earthquake-asia-action-against-hunger-takes-action-afghanistan-and-pakistan
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</div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="schema:text content:encoded"><blockquote><p><strong>A strong earthquake with a magnitude of 7.5 struck on Monday, October 26th in northeastern Afghanistan. The earthquake was felt particularly in Pakistan, Afghanistan, and India. Action Against Hunger teams will launch assessments in the affected areas.</strong></p>
<p>The provisional toll reported at least 100 dead across the region. This is a number that may rise in the coming hours according to Brian Hansen, director of Action Against Hunger's operations in Afghanistan. "The human toll continues to rise and house demolitions are also many, however it is much too early to give precise information about the situation because telecommunications are cut in large areas of the country," he said.</p>
<p>The quake was felt in most Afghan provinces with stronger shocks in the northern provinces, including Panjshir, Badakhshan, Nuristan, Kapisa, and Kunduz. According to the American Geological Institute, the epicenter would be at Jurm in Badakhshan province in the far northeast of Afghanistan, and at a depth of 213.5 kilometers. This earthquake felt akin to Nepal, where Action Against Hunger intervened following a similar disaster there six months ago. </p>
<p>Present in Pakistan, Afghanistan, and India, Action Against Hunger teams will travel to the affected areas to observe the extent of damage and needs in the northeast of Afghanistan, and work with local authorities to observe the damage in our present program areas in Khyber Pakhtunkhwa in Pakistan. A humanitarian response may be considered to help those affected by the earthquake, according to the situation.</p>
<p><strong>Spokesperson available for interview</strong></p>
<p><em>Press contact: Julia Belusa - </em><a href="http://anws.co/bc06n/%7Bbebd6598-084d-46b5-a8bd-61763cc761fa%7D" target="_blank">jbelusa@actioncontrelafaim.org</a> <br />
01 70 84 72 22/06 70 01 58 43</p>
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</div></div></div><span rel="schema:url" resource="/blog/earthquake-asia-action-against-hunger-takes-action-afghanistan-and-pakistan" class="rdf-meta element-hidden"></span><span property="schema:name" content="Earthquake in Asia: Action Against Hunger Takes Action in Afghanistan and Pakistan" class="rdf-meta element-hidden"></span>Mon, 26 Oct 2015 18:27:49 +0000erapport7571 at http://www.actionagainsthunger.orgA Success Story in Badinhttp://www.actionagainsthunger.org/blog/success-story-badin
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<div class="field-item even" rel="schema:image" resource="http://www.actionagainsthunger.org/sites/default/files/images/blog-posts/Last_Day_at_OTP_site-Pic_3-ACF_Pakistan-Riaz_Ali_Khoso.jpg"><img typeof="foaf:Image" src="http://www.actionagainsthunger.org/sites/default/files/images/blog-posts/Last_Day_at_OTP_site-Pic_3-ACF_Pakistan-Riaz_Ali_Khoso.jpg" width="900" height="674" alt="Nazeer, feeling much better after treatment. Credit: Riaz Ali Khoso for Action Against Hunger" title="Nazeer, feeling much better after treatment. Credit: Riaz Ali Khoso for Action Against Hunger" />
<div class="caption">Nazeer, feeling much better after treatment. Credit: Riaz Ali Khoso for Action Against Hunger</div>
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</div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="schema:text content:encoded"><p>Last fall, Action Against Hunger’s nutrition team visited the village Mir Hoat in the Badin district of Sindh province, Pakistan, where malnutrition rates are consistently over the emergency threshold. Over 18% of the children are malnourished in Mir Hoat, with nearly 4% of children suffering from severe acute malnutrition. While our team was screening children for malnutrition, they met Noor Bano, a mother of four. Her eldest child, Nazeer Ahmad, who was one month from his fifth birthday, was severely malnourished, weighing a mere 17 pounds.</p>
<p>Noor Bano told the nutrition team that she had taken Nazeer to many private doctors in the past. It helped him in the short-term, but his overall health did not improve. Our team referred her to the nearest Action Against Hunger center where Nazeer was enrolled in the Out-Patient Therapeutic Program (OTP) to receive treatment for undernutrition. The team also visited Noor Bano's home to assess for the underlying causes of malnutrition, such as poor feeding and hygiene practices. They found that the children's grandmother, Maryam, was the primary caretaker while Noor Bano and her husband worked in the fields.</p>
<p>Maryam was counseled on how diet diversity and good hygiene practices can prevent further malnutrition. Seasonal vegetables like spinach, okra, eggplant, and gourds were encouraged, as were staple foods like rice and wheat products. The team also promoted locally available fruits like mango, banana, papaya, dates, and chikoo and proteins like milk and milk products, meat products, and eggs. Nazeer's nutritional status improved greatly thanks to the therapeutic foods, improved hygiene conditions, age-appropriate feeding, and a strengthened immune system.</p>
<p>Action Against Hunger is part of the Pakistan Emergency Food Security Alliance. This is a consortium of six International Non-Governmental Organizations, supported by the European Union, which seeks to bring about a shift in chronic food insecurity while providing innovative solutions to overcome malnutrition by addressing the underlying causes. Using an integrated approach and pooling resources and technical expertise, the project continues to provide essential nutrition support for thousands of malnourished children, just like Nazeer.</p>
</div></div></div><span rel="schema:url" resource="/blog/success-story-badin" class="rdf-meta element-hidden"></span><span property="schema:name" content="A Success Story in Badin" class="rdf-meta element-hidden"></span>Mon, 20 Jul 2015 16:41:33 +0000lsepuka7459 at http://www.actionagainsthunger.orgBuilding Healthy Families in Daduhttp://www.actionagainsthunger.org/blog/building-healthy-families-dadu
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<div class="caption">Murak after treatment. Photo by Irfan Akbar.</div>
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</div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="schema:text content:encoded"><p>Ghulam Shabir Panhwar, a farmer and father of five, lives with his wife and children in the village of Sultan Bhatti near the Dadu district of Sindh province, Pakistan. When he brought his eight-month-old daughter, Murak, to the Basic Health Unit in Kolachi for the treatment of fever, she was found to be severely malnourished, weighing under nine pounds. </p>
<p>She was treated for fever and then referred to the outpatient therapeutic program established at the same health facility for the treatment of severe acute malnutrition. While collecting Murak's medical history, the nurse noted an imbalanced diet, improper feeding care, and poor sanitation and hygiene practices—all known causes of malnutrition.</p>
<p>When she was stable enough, Murak was treated with Ready-to-Use Therapeutic Foods, specially formulated to treat severe malnutrition in children under five years of age. Her mother participated in Action Against Hunger’s infant and young child feeding program where she learned how to prepare healthy complementary food, how to replace bottle feeding with a young infant feeding cup, and good sanitation and hygiene practices to prevent further malnutrition in her family.</p>
<p>After 12 weeks of treatment, Murak weighs nearly 15 pounds and enjoys good health. Last year, Action Against Hunger provided essential nutrition support to over 8,000 severely malnourished children in Dadu just like Murak, and treated over 4,000 malnourished pregnant and lactating women.</p>
<p><strong>Unza</strong></p>
<p>Zameer, a father of four, lives in the village of Sendhal Mahesar Muhalla near the Dadu district of Sindh province, Pakistan. He brought his youngest daughter, 25-month-old Unza to the Mehar Taluka hospital for treatment of a minor skin infection, where she was also diagnosed with and treated for severe acute malnutrition. She was provided with medications to support her skin infection and was scheduled for a follow up visit in two weeks.</p>
<p><picture title="Unza before treatment. Photo by Haq Nawaz." data-picture-mapping="blog" class="image-blog_post_2013" height="607" width="638">
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<p>However, three days later, Unza’s family brought her back to the treatment site as she had began to suffer diarrhea and vomiting, which resulted in sudden weight loss. Looking at her condition, the nurse at the outpatient therapeutic program suggested that Unza be admitted into inpatient care in what is known as a stabilization center. Unza stayed in the inpatient care for four days. Her treatment was successful and her appetite recovered, so she was discharged from the stabilization center and re-admitted in the outpatient program to continue with treatment for severe malnutrition with Ready-to-Use Therapeutic Foods and routine medications.</p>
<p>Her mother attended various health and nutritional sessions along with counseling to prevent malnutrition in the future. She said, "We had lost the hope that our baby would survive this condition, but now Unza has a second chance. We are thankful for the support we received as well as the guidance on ways to prevent malnutrition through good health and nutritional practices in daily life.”</p>
<p><picture title="Unza after treatment. Photo by Haq Nawaz." data-picture-mapping="blog" class="image-blog_post_2013" height="829" width="638">
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<p>Action Against Hunger began working in Pakistan in 1979. Today, we continue to work side by side with the government and other organizations in the fight against hunger. Our staff of over 450 people works from our base in the capital city of Islamabad and field offices in the Peshawar, Timergara, and Kohat districts of Khyber Pakhtunkhwa province and the Tando Muhammad Khan, Badin, and Dadu districts of Sindh Province.</p>
<p><em>Support for this program is provided through the WINS (Women and Children/Infants Improved Nutrition Sindh) program, funded by the European Union. Action Against Hunger’s Project for Dadu district provides preventative and curative nutrition interventions via strengthened Government health facilities, coupled with food security as well as water, hygiene, and sanitation programs.</em></p>
</div></div></div><span rel="schema:url" resource="/blog/building-healthy-families-dadu" class="rdf-meta element-hidden"></span><span property="schema:name" content="Building Healthy Families in Dadu" class="rdf-meta element-hidden"></span>Mon, 20 Apr 2015 14:05:09 +0000lsepuka7380 at http://www.actionagainsthunger.orgGardens Help Children Grow in Pakistanhttp://www.actionagainsthunger.org/blog/gardens-help-children-grow-pakistan
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<div class="caption">Rasheedan's kitchen garden. Photo by Allah Dino.</div>
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</div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="schema:text content:encoded"><p>Rasheedan, 34, lives with her husband and children in the Dadu district of Sindh province, Pakistan, where last year, Action Against Hunger treated over 8,000 children suffering from severe acute malnutrition. Although her children have not been identified as severely malnourished, they are still at risk due to feeding practices and lack of access to diversified, nutrient-rich food and clean water.</p>
<p>Kitchen gardens are an invaluable tool for food and nutrition security in vulnerable communities like Rasheedan’s, so we provided Rasheedan and over 4,500 other women in Dadu with seeds for 11 different assorted vegetables, gardening tools, and training on how to establish a kitchen garden. In its simplest form, the kitchen garden produces fresh vegetables for healthy, nutritious meals, helping families diversify their food source in order to prevent undernutrition. Rasheedan and the other women also attended nutrition awareness sessions which showed how dietary diversity and good hygiene practices, such as handwashing, can prevent malnutrition.</p>
<p><img alt="" class="image-blog_post_2013" height="479" src="http://www.actionagainsthunger.org/sites/default/files/styles/blog_post_2013/public/6_Rasheedan_cooking_harvested_vegetables_-_Photo_by_Allah_Dino.JPG?itok=VWrUQ9ef" title="Rasheedan cooking harvested vegetables. Photo by Allah Dino." width="638" /></p>
<p>Within two months of starting her garden, Rasheedan’s plants began bearing fruit—first tomatoes and onions, then okra. She soon produced three months’ worth of vegetables for her family. Before, nearly one-third of her family’s monthly earnings went towards buying vegetables, money that her kitchen garden now allows her to save. Eventually, she grew enough vegetables that she was able to sell and store some. Rasheedan shared how the garden provides her with peace of mind, “I feel confident that I know how to ensure availability of a variety of vegetables throughout the year in my own garden.”</p>
<p><em>Support for this program is provided through the WINS (Women and Children/Infants Improved Nutrition Sindh) program, funded by the European Union. Action Against Hunger’s Project for Dadu district provides preventative and curative nutrition interventions via strengthened Government health facilities, coupled with food security as well as water, hygiene, and sanitation programs.</em></p>
</div></div></div><span rel="schema:url" resource="/blog/gardens-help-children-grow-pakistan" class="rdf-meta element-hidden"></span><span property="schema:name" content="Gardens Help Children Grow in Pakistan" class="rdf-meta element-hidden"></span>Thu, 16 Apr 2015 13:33:18 +0000lsepuka7378 at http://www.actionagainsthunger.org